Healthcare Provider Details

I. General information

NPI: 1457209439
Provider Name (Legal Business Name): THOMAS HERITAGE & WELLNESS GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S 336TH ST
FEDERAL WAY WA
98003-6385
US

IV. Provider business mailing address

555 ANDOVER PARK W STE 200
TUKWILA WA
98188-3379
US

V. Phone/Fax

Practice location:
  • Phone: 206-852-1234
  • Fax:
Mailing address:
  • Phone: 206-852-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. JOYCELYN RENE THOMAS
Title or Position: OWNER
Credential: DNP, MN, APRN, FNP
Phone: 206-852-1234